慢性心力衰竭患者红细胞分布宽度改变的影响因素分析

Analysis of influencing factors of red blood cell distribution width in patients with chronic heart failure

目的探讨慢性心力衰竭(CHF)患者红细胞分布宽度(RDW)改变的影响因素。方法选取2016年9月~2018年5月在山西医科大学附属汾阳医院心血管内科住院的CHF患者136例,依据RDW水平将患者分为低RDW组(RDW<13.2%,43例)、中RDW组(RDW=13.2%~14.5%,47例)和高RDW组(RDW>14.5%,46例)。比较三组患者的基本临床资料、实验室检查资料及红细胞膜Na^+/K^+-ATPase、Ca^2+/Mg^2+-ATPase活性,并通过多元线性回归分析影响CHF患者RDW改变的因素。结果各组血红蛋白、白蛋白、直接胆红素、左室射血分数(LVEF)、logN末端脑钠肽(NT-proBNP)、红细胞膜Na^+/K^+-ATPase、Ca^2+/Mg^2+-ATPase活性比较,差异有统计学意义(P<0.05)。CHF患者RDW与LVEF、白蛋白、直接胆红素、红细胞膜Na^+/K^+-ATPase、Ca^2+/Mg^2+-ATPase活性有关,其回归系数分别为-0.104、-0.133、0.111、-0.577、-0.263(P<0.05)。结论LVEF、白蛋白、直接胆红素、红细胞膜Na^+/K^+-ATPase、Ca^2+/Mg^2+-ATPase活性是影响CHF患者RDW的因素,RDW对CHF的病情评估、治疗效果及预后预测等具有一定的价值。

Objective To investigate the influencing factors of red blood cell distribution width (RDW) in patients with chronic heart failure (CHF).Methods From September 2016 to May 2018,136 patients with CHF who were hospitalized in the Department of Cardiovascular Medicine,Fenyang Hospital Affiliated to Shanxi Medical University were enrolled.According to the RDW level,patients were divided into low RDW group (RDW < 13.2%,43 cases),medium RDW group (RDW = 13.2%- 14.5%,47 cases) and high RDW group (RDW > 14.5%,46 cases).The basic clinical data,laboratory data and activities of Na^+/K^+-ATPase and Ca^2+/Mg^2+-ATPase in erythrocyte membranes of the three groups were compared,and the factors affecting the changes of RDW in CHF patients were analyzed by multiple linear regression.Results There were significant differences in hemoglobin,albumin,direct bilirubin,left ventricular ejection fraction (LVEF),log N-terminal brain natriuretic peptide (NT-proBNP),Na^+/K^+-ATPase and Ca^2+/Mg^2+-ATPase activities in erythrocyte membrane among the groups (P < 0.05).RDW in patients with CHF was associated with LVEF,albumin,direct bilirubin,Na+/K+-ATPase,Ca^2+/Mg^2+-ATPase activity in erythrocyte membrane,and the regression coefficients were -0.104,-0.133,0.111,-0.577,-0.263,respectively (P < 0.05).Conclusion LVEF,albumin,direct bilirubin,Na^+/K^+-ATPase and Ca^2+/Mg^2+-ATPase activity in erythrocyte membrane are the factors affecting RDW in patients with CHF.RDW has certain value in evaluating the condition,therapeutic effect and prognosis of CHF.